Abstract
Background
Osteoporosis is a systemic skeletal disease of multi-aetiological origin and is a
major factor in health economics. The reduction in bone mass and disruption of the
microarchitecture lead to an increased risk of fracture. The therapy is versatile,
with orthoses being used in the treatment of acute vertebral fractures as well as
chronic pain.
Objectives
The aim of this work is to formulate evidence-based recommendations for the use of
orthoses in osteoporotic vertebral fractures and chronic symptoms.
Methodology
The literature search was conducted according to the PRISMA protocol at PubMed, ScienceDirect,
Cochrane and Google Scholar. The risk of bias of the studies was assessed using RoB2
for randomised studies and ROBINS-I for non-randomised studies. The level of evidence
was determined according to AHCPR.
Results
A total of 18 studies were identified, with 11 studies focussing on the treatment
of chronic back pain in osteoporosis and 7 studies on pain therapy for acute osteoporotic
vertebral fractures. The non-RCTs matched 5× to evidence levels IIa. The risk of bias
was 10× moderate, 4× severe and 3× critical. The RCTs could be divided by the following
evidence levels: 10× Ib, 1× IIb, 1× III and 1× IV. The risk of bias was 10× moderate
and 3× critical.
Conclusions
In the case of chronic back pain, the use of orthoses leads to a reduction in pain
and has a positive effect on back extensor strength, but a significant reduction in
pain cannot be achieved in osteoporosis-associated vertebral body fractures. The currently
available literature do not support the superiority of a specific type of orthosis.
Keywords
orthosis - osteoporosis - vertebral fractures - chronic back pain - risk of bias
